Erdem, H. (7005578733)H. (7005578733)ErdemOzturk-Engin, D. (25622697400)D. (25622697400)Ozturk-EnginElaldi, N. (55928536800)N. (55928536800)ElaldiGulsun, S. (9842077500)S. (9842077500)GulsunSengoz, G. (23009761400)G. (23009761400)SengozCrisan, A. (57220344976)A. (57220344976)CrisanJohansen, I.S. (55330822600)I.S. (55330822600)JohansenInan, A. (9843845700)A. (9843845700)InanNechifor, M. (7006100922)M. (7006100922)NechiforAl-Mahdawi, A. (6603126939)A. (6603126939)Al-MahdawiCivljak, R. (7801604292)R. (7801604292)CivljakOzguler, M. (56090892000)M. (56090892000)OzgulerSavic, B. (7004671656)B. (7004671656)SavicCeran, N. (6506778903)N. (6506778903)CeranCacopardo, B. (7003926073)B. (7003926073)CacopardoInal, A.S. (57197164912)A.S. (57197164912)InalNamiduru, M. (6602332685)M. (6602332685)NamiduruDayan, S. (55000710700)S. (55000710700)DayanKayabas, U. (13004585100)U. (13004585100)KayabasParlak, E. (7004037768)E. (7004037768)ParlakKhalifa, A. (26027528400)A. (26027528400)KhalifaKursun, E. (55356654900)E. (55356654900)KursunSipahi, O.R. (10340240700)O.R. (10340240700)SipahiYemisen, M. (57208572543)M. (57208572543)YemisenAkbulut, A. (6701550061)A. (6701550061)AkbulutBitirgen, M. (10046013800)M. (10046013800)BitirgenDulovic, O. (6602485522)O. (6602485522)DulovicKandemir, B. (16686312900)B. (16686312900)KandemirLuca, C. (7006040019)C. (7006040019)LucaParlak, M. (57935167700)M. (57935167700)ParlakStahl, J.P. (7202873929)J.P. (7202873929)StahlPehlivanoglu, F. (36560231700)F. (36560231700)PehlivanogluSimeon, S. (56091330000)S. (56091330000)SimeonUlu-Kilic, A. (36873252700)A. (36873252700)Ulu-KilicYasar, K. (14323903800)K. (14323903800)YasarYilmaz, G. (57220513488)G. (57220513488)YilmazYilmaz, E. (22037135100)E. (22037135100)YilmazBeovic, B. (55887249900)B. (55887249900)BeovicCatroux, M. (56091442200)M. (56091442200)CatrouxLakatos, B. (36614563800)B. (36614563800)LakatosSunbul, M. (7004406526)M. (7004406526)SunbulOncul, O. (56194760300)O. (56194760300)OnculAlabay, S. (55866937900)S. (55866937900)AlabaySahin-Horasan, E. (56091331600)E. (56091331600)Sahin-HorasanKose, S. (24401322500)S. (24401322500)KoseShehata, G. (56051054400)G. (56051054400)ShehataAndre, K. (56090809900)K. (56090809900)AndreAlp, A. (7003572097)A. (7003572097)AlpĆosić, G. (56507327000)G. (56507327000)ĆosićCem Gul, H. (23094226600)H. (23094226600)Cem GulKarakas, A. (37074784800)A. (37074784800)KarakasChadapaud, S. (23567706200)S. (23567706200)ChadapaudHansmann, Y. (7004018698)Y. (7004018698)HansmannHarxhi, A. (8690048500)A. (8690048500)HarxhiKirova, V. (56091200300)V. (56091200300)KirovaMasse-Chabredier, I. (56090828500)I. (56090828500)Masse-ChabredierOncu, S. (55945280700)S. (55945280700)OncuSener, A. (23996235800)A. (23996235800)SenerTekin, R. (36599200500)R. (36599200500)TekinDeveci, O. (55676015400)O. (55676015400)DeveciKarabay, O. (23060531400)O. (23060531400)KarabayAgalar, C. (6602534012)C. (6602534012)Agalar2025-06-122025-06-122014https://doi.org/10.1111/1469-0691.12478https://www.scopus.com/inward/record.uri?eid=2-s2.0-84913605718&doi=10.1111%2f1469-0691.12478&partnerID=40&md5=24ae1793e7500e01d035e459c0743d8chttps://remedy.med.bg.ac.rs/handle/123456789/8522We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon-γ release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Löwenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p <0.05 for both). Accordingly, CSF L-J culture was superior to CSF-PCR (p <0.05). Combination of L-J and ACS was superior to using these tests alone (p <0.05). There were poor and inverse agreements between EZNs and L-J culture (κ = -0.189); ACS and L-J culture (κ = -0.172) (p <0.05 for both). Fair and inverse agreement was detected for CSF-ADA and CSF-PCR (κ = -0.299, p <0.05). Diagnostic accuracy of TBM was increased when both ACS and L-J cultures were used together. Non-culture tests contributed to TBM diagnosis to a degree. However, due to the delays in the diagnosis with any of the cultures, combined use of non-culture tests appears to contribute early diagnosis. Hence, the diagnostic approach to TBM should be individualized according to the technical capacities of medical institutions particularly in those with poor resources. © 2013 European Society of Clinical Microbiology and Infectious Diseases.PCRCultureDiagnosisMeningitisTuberculosis